Cardiac rehabilitation: Unraveling the complexity of referral and current models of delivery

Astley, CM; Neubeck, L; Gallagher, R; Berry, N; Du, H; Hill, MN; Clark, RA

Cardiac rehabilitation: Unraveling the complexity of referral and current models of delivery

Astley, CM Neubeck, L Gallagher, R

Berry, N Du, H Hill, MN Clark, RA

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Publication Type:: Journal Article
Citation:: Journal of Cardiovascular Nursing, 2017, 32 (3), pp. 236 - 243
Issue Date:: 2017-01-01

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Field	Value	Language
dc.contributor.author	Astley, CM	en_US
dc.contributor.author	Neubeck, L	en_US
dc.contributor.author	Gallagher, R https://orcid.org/0000-0001-5588-9351	en_US
dc.contributor.author	Berry, N	en_US
dc.contributor.author	Du, H	en_US
dc.contributor.author	Hill, MN	en_US
dc.contributor.author	Clark, RA	en_US
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	Journal of Cardiovascular Nursing, 2017, 32 (3), pp. 236 - 243	en_US
dc.identifier.issn	0889-4655	en_US
dc.identifier.uri	http://hdl.handle.net/10453/113602
dc.description.abstract	Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. Background: Evidence-based guidelines recommend strategies for reducing risk factors for secondary prevention of acute coronary syndromes, yet referral to and completion of programs to deliver this advice are poor. Purpose: In this article we describe the complexity of factors that influence referral and delivery of evidence-based cardiac rehabilitation (CR) programs through an Australian context and provide direction for solutions for clinicians and policy makers to consider. The Ecological Approach is used as a framework to synthesize evidence. The approach has 5 categories, the characteristics of which may act as barriers and enablers to the promotion and adoption of health behaviors and includes (a) interpersonal factors, (b) interpersonal factors, (c) institutional factors, (d) community networks, and (e) public policy. Conclusions: Despite the context of strong evidence for efficacy, this review highlights systematic flaws in the implementation of CR, an important intervention that has been shown to improve patient outcomes and prevent cardiac events. Recommendations from this review include standardization of program delivery, improvement of data capture, use of technological innovations and social networks to facilitate delivery of information and support, and establishment of a cohesive, consistent message through interorganizational collaboration involved in CR. Clinical Implications: These avenues provide direction for potential solutions to improve the uptake of CR and secondary prevention.	en_US
dc.relation.ispartof	Journal of Cardiovascular Nursing	en_US
dc.relation.isbasedon	10.1097/JCN.0000000000000332	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Referral and Consultation	en_US
dc.subject.mesh	Delivery of Health Care	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Secondary Prevention	en_US
dc.subject.mesh	Cardiac Rehabilitation	en_US
dc.title	Cardiac rehabilitation: Unraveling the complexity of referral and current models of delivery	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	32	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	32	en_US

Abstract:

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. Background: Evidence-based guidelines recommend strategies for reducing risk factors for secondary prevention of acute coronary syndromes, yet referral to and completion of programs to deliver this advice are poor. Purpose: In this article we describe the complexity of factors that influence referral and delivery of evidence-based cardiac rehabilitation (CR) programs through an Australian context and provide direction for solutions for clinicians and policy makers to consider. The Ecological Approach is used as a framework to synthesize evidence. The approach has 5 categories, the characteristics of which may act as barriers and enablers to the promotion and adoption of health behaviors and includes (a) interpersonal factors, (b) interpersonal factors, (c) institutional factors, (d) community networks, and (e) public policy. Conclusions: Despite the context of strong evidence for efficacy, this review highlights systematic flaws in the implementation of CR, an important intervention that has been shown to improve patient outcomes and prevent cardiac events. Recommendations from this review include standardization of program delivery, improvement of data capture, use of technological innovations and social networks to facilitate delivery of information and support, and establishment of a cohesive, consistent message through interorganizational collaboration involved in CR. Clinical Implications: These avenues provide direction for potential solutions to improve the uptake of CR and secondary prevention.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/113602